[Quality of life of people with Parkinson's disease during confinement due to the covid-19 pandemic]. / Calidad de vida de las personas con enfermedad de Parkinson durante el confinamiento por la pandemia por covid-19.

INTRODUCTION: The study was aimed to explore the quality of life of people with Parkinson's disease during confinement due to the coronavirus infectious disease 2019 (covid-19) pandemic. MATERIAL AND METHODS: The study was quantitative, descriptive and correlational. The sample was 51 people with Parkinson's disease, from the region of Magallanes and Chilean Antarctica, and whose information was collected from the database of the Rehabilitation Corporation Club de Leones Cruz del Sur, to which they belong. RESULTS: The main results show that 51.6% of people with Parkinson's disease report a «good and very good¼ quality of life and that the main domains of the Parkinson's Disease Questionnaire (PDQ-39) affected are: body discomfort, mobility and emotional well-being. According to the analysis of the qualitative ranges of the PDQ-39, the dimensions that were most compromised during the confinement by the covid-19 pandemic were: communication, stigma and emotional well-being. In addition, women had a poorer quality of life than men. Finally, it was shown that the progression of symptoms affects the quality of life of people with Parkinson's disease. CONCLUSIONS: In conclusion, during the confinement due to the covid-19 pandemic people with Parkinson's disease increased symptoms and presented a lower quality of life, especially women.

Telerehabilitación en alta latitud sur. Resultados de una implementación de tratamiento para personas en situación de discapacidad durante la pandemia de COVID-19 / Telerehabilitation in the high southern latitude. Results of a treatment implementation for people with disabilities during the COVID-19 pandemic

La situación sanitaria generada por la aparición de la COVID-19 ha precipitado el uso de nuevas tecnologías y la adaptación de los servicios de rehabilitación de todo tipo. Objetivo: Describir la implementación de un sistema de telerehabilitación en pacientes con diferentes diagnósticos de discapacidad que viven en alta latitud sur, durante la pandemia de COVID-19. Métodos: Se implementó un sistema de terapias personalizadas guiadas mediante videoconferencia para pacientes con diferentes diagnósticos de discapacidad. Los pacientes se agruparon en tres grupos etarios (menores, adultos, adultos mayores) y seis tipos de diagnóstico clínico (afecciones originadas en el periodo perinatal, enfermedades del sistema circulatorio, enfermedades del sistema nervioso, enfermedades del sistema osteomuscular y del tejido conjuntivo, tratamientos mentales y del comportamiento y otro tipo de diagnósticos). Se evaluó el diagnóstico del paciente, el tipo de atención requerida, el número de sesiones y el nivel de satisfacción de cada usuario en función de la telerehabilitación que recibieron. Resultados: Participaron 101 pacientes con edad promedio de 31±26 años, siendo el 52,5% de estos del sexo masculino. Todos ellos logran manejar tecnologías mínimas requeridas para la atención por telerehabilitación. Existe un grado de asociación entre el diagnóstico del paciente y el grupo etario (p<0,05), así como también entre el diagnóstico y el tipo de atención requerida (p<0,05). Tras la implementación, los usuarios y usuarias evalúan positivamente la terapia a distancia. Conclusiones: La telerehabilitación puede ser implementada en pacientes con discapacidad en zonas de alta latitud sur, respetando las diferentes etapas del proceso, para asegurar una correcta ejecución.

The health situation after the emergence of COVID-19 has precipitated the use of new technologies and the adaptation of rehabilitation services of all kinds. Objective: To describe the implementation of a telerehabilitation system in patients with different diagnoses of disability living in the high southern latitude during the COVID-19 pandemic. Methods: A system of personalized therapies guided by videoconference was implemented for patients with varying diagnoses of disability. The patients were grouped into three age groups (Minors; Adults; Older Adults) and six types of clinical diagnosis (conditions originating in the perinatal period, diseases of the circulatory system, diseases of the nervous system, diseases of the musculoskeletal system, and connective tissue, mental and behavioural treatments and other diagnoses). The patient's diagnosis, the type of care required, the number of sessions, and the level of satisfaction of each user were evaluated based on the telerehabilitation they received. Results: 101 patients with an average age of 31±26 years participated, 52.5% were male. All of them managed to handle the minimum technologies required for telerehabilitation care. There is a degree of association between the patient's diagnosis and the age group (p<.05), as well as between the diagnosis and the type of care required (p<.05). After implementation, users positively evaluated distance therapy. Conclusions: Telerehabilitation can be implemented in patients with disabilities in areas of high southern latitude, respecting the different stages of the process, to ensure it is correctly delivered.

Intermittent hypobaric hypoxia combined with aerobic exercise improves muscle morphofunctional recovery after eccentric exercise to exhaustion in trained rats.

Unaccustomed eccentric exercise leads to muscle morphological and functional alterations, including microvasculature damage, the repair of which is modulated by hypoxia. We present the effects of intermittent hypobaric hypoxia and exercise on recovery from eccentric exercise-induced muscle damage (EEIMD). Soleus muscles from trained rats were excised before (CTRL) and 1, 3, 7, and 14 days after a double session of EEIMD protocol. A recovery treatment consisting of one of the following protocols was applied 1 day after the EEIMD: passive normobaric recovery (PNR), a 4-h daily exposure to passive hypobaric hypoxia at 4,000 m (PHR), or hypobaric hypoxia exposure followed by aerobic exercise (AHR). EEIMD produced an increase in the percentage of abnormal fibers compared with CTRL, and it affected the microvasculature by decreasing capillary density (CD, capillaries per mm2) and the capillary-to-fiber ratio (CF). After 14 days, AHR exhibited CD and CF values similar to those of CTRL animals (789 and 3.30 vs. 746 and 3.06) and significantly higher than PNR (575 and 2.62) and PHR (630 and 2.92). Furthermore, VEGF expression showed a significant 43% increase in AHR when compared with PNR. Moreover, after 14 days, the muscle fibers in AHR had a more oxidative phenotype than the other groups, with significantly smaller cross-sectional areas (AHR, 3,745; PNR, 4,502; and PHR, 4,790 µm2), higher citrate synthase activity (AHR, 14.8; PNR, 13.1; and PHR, 12 µmol·min-1·mg-1) and a significant 27% increment in PGC-1α levels compared with PNR. Our data show that hypoxia combined with exercise attenuates or reverses the morphofunctional alterations induced by EEIMD.NEW & NOTEWORTHY Our study provides new insights into the use of intermittent hypobaric hypoxia combined with exercise as a strategy to recover muscle damage induced by eccentric exercise. We analyzed the effects of hypobaric exposure combined with aerobic exercise on histopathological features of muscle damage, fiber morphofunctionality, capillarization, angiogenesis, and the oxidative capacity of damaged soleus muscle. Most of these parameters were improved after a 2-wk protocol of intermittent hypobaric hypoxia combined with aerobic exercise.

A semiquantitative scoring tool to evaluate eccentric exercise-induced muscle damage in trained rats.

Unaccustomed eccentric exercise is a well-documented cause of exercise-induced muscle damage. However, in trained subjects muscle injury involves only light or moderate tissue damage. Since trained rats are widely used as a model for skeletal muscle injury, here we propose a semiquantitative scoring tool to evaluate muscle damage in trained rats. Twenty male Sprague-Dawley rats were trained fortwo weeks following a two-week preconditioning period, and randomly divided into two groups: control rats (CTL; n=5) and rats with eccentric exercise-induced muscle damage (INJ; n=15). Injured rats were sacrificed at three time points: 1, 3 and 7 days post injury (n=5 each). Transverse sections from the right soleus were cut (10 µm) and stained with haematoxylin-eosin. Samples were evaluated by two groups of observers (four researchers experienced in skeletal muscle histopathology and four inexperienced) using the proposed tool, which consisted of six items organised in three domains: abnormal fibre morphology, necrotic/(re)degenerating fibres (muscle fibre domain), endomysial and perimysial infiltration (inflammatory state domain) and endomysium and perimysium distension (interstitial compartment domain). We observed the expected time course in the six evaluated items. Furthermore, agreement among observers was evaluated by measuring the Intraclass Correlation Coefficient (ICC). Within the experienced group, items from the muscle fibre and interstitial compartment domains showed good agreement and the two items from the infiltration compartment domain showed excellent agreement. in conclusion, the proposed tool allowed quick and correct evaluation of light to moderate muscle damage in trained rats with good agreement between observers.